Indirect Hernias Should Not be Fixed with Mesh
There are two different types of hernias that occur in the inguinal region. The most common type is an indirect inguinal hernia. A indirect hernia is a congenital hernia. Just before a male is born, the testicle pops out through a small hole in the abdominal wall and drops down into the scrotum. That hole is supposed to close after the testicle passes through. Sometimes it is does not and then at later date that hole can become enlarged after an accident or strain. Once the hole becomes large enough, then intestines will slide through the hole and create a bulge. The important thing to remember is that with indirect hernias the tissues and muscles in the area are healthy and strong, and that the only problem is that there is a hole that did not close when it was supposed to. Woman also have a natural hole in the same location, but women never use the hole and the ovary remains in the pelvis. Thus women can also have indirect hernias.
Since the muscles and tissues in the region are healthy, one could think that mesh would not be needed. There are very few articles that separate out indirect hernia repairs. The two articles below document that non mesh repairs have excellent and probably better results than mesh repairs in patients who have indirect hernias, especially in the younger patients. If you have an indirect hernia, strongly consider a non mesh repair.
Low reoperation rates in young males after sutured repair of indirect inguinal hernia: Arguments for a tailored approach
Herniotomy in young adults as an alternative to mesh repair: a retrospective cohort study